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CLINICAL RESEARCH: CARDIAC PACEMAKERS

Clinical study of interference with cardiac pacemakers by a magnetic field at power line frequencies

Alexandre Trigano, MD^*,*, Olivier Blandeau, BS^*, Martine Souques, MD, Jean Pierre Gernez, BS and Isabelle Magne, PhD

^* Department of Cardiology, Centre Hospitalier Universitaire Nord, Marseille, France
Department of Medical Studies, Electricité de France, EDF-Gaz de France, Paris, France
Electricité de France Research and Development, Electrical Laboratories, Electromagnetic Compatibility Group, Moret-sur-Loing, France

Manuscript received August 22, 2004; accepted October 18, 2004.

^* Reprint requests and correspondence: Dr. Alexandre Trigano, Centre Hospitalier Universitaire Nord, Hôpital Nord, 13915 cedex 20, Marseille, France (Email: alexandre.trigano{at}mail.ap-hm.fr).

OBJECTIVES: This study examined the risk of interference by high magnetic flux density with permanent pacemakers.

BACKGROUND: Several forms of electromagnetic energy may interfere with the functions of implanted pacemakers. No clinical study has reported specific and relevant information pertaining to magnetic fields near power lines or electrical appliances.

METHODS: A total of 250 consecutive tests were performed in 245 recipients of permanent pacemakers during 12-lead electrocardiographic monitoring. A dedicated exposure system generated a 50-Hz frequency and maximum 100-µT flux density, while the electrical field was kept at values on the order of 0.10 V/m.

RESULTS: A switch to the asynchronous mode was recorded in three patients with devices programmed in the unipolar sensing configuration. A sustained mode switch was followed by symptomatic pacing inhibition in one patient. No effect on devices programmed in bipolar sensing was observed, except for a single interaction with a specific capture monitoring algorithm.

CONCLUSIONS: The overall incidence of interaction by a magnetic field was low in patients tested with a wide variety of conventionally programmed pacemaker models. A magnetic field pulsed at power frequency can cause a mode switch and pacing inhibition in patients with devices programmed in the unipolar sensing configuration. The risk of interference appears negligible in patients with bipolar sensing programming.

Abbreviations and Acronyms   AVB = atrioventricular block   ECG = electrocardiogram   EMI = electromagnetic interference